Objective To discuss morphology and biomechanics of the sacrum fractures so as to provide scientific basis for corresponding clinical treatment. Methods A total of 10 fresh pelvis specimens were collected for dynamic impact test and static destruction test, in the former one of which, the dynamic parameters were measured to make sure the dynamic characters of the fractures. Meanwhile, the fractures of the sacrum wing, the sacral foramina and the sacrum edge were made decalcification, slice of paraffin wax and staining (Masson, Mallory, HE) in order to make a cytological observation of the tissue. Results (1) The form of sacrum fracture or acetabulum fracture, crista iliaceis fracture was relevant to the impact energy. Low impact energy usually caused fractures of the ilium, acetabulum or sacroiliac crest. High impact energy resulted in following three kinds of fractures, just as the classification of Denis: sacral ala fractures belonged to typeⅠfractures, sacral hiatus fractures to type Ⅱ fractures and central vertebral canal fractures to type Ⅲ fractures. All three types of fractures might involve lateral or bilateral nerve roots. (2) There was a significant mechanic difference in regard of the mechanism of both dynamic destruction and static destruction of pelvis, ie, not only the limit pressure differed but also the former increased rapidly with the higher rate of the strain. The clash energy beyond 25 J would beget the cleft fractures of the sacrum via sacrum hiatus and even involve the nerve roots. The clash energy under 20 J usually resulted in fractures of the ilium and the sacrum. The clash energy between 20 J and 25 J more easily caused type Ⅰ fractures. While fracture of the ilium and the acetabulum would happen most in static destruction. (3) The cross section of the sacrum was cracked and the bone board of Haversian system is brittle, as led to separation of bone board and malposition of a few cross bone boards. Conclusions Under dynamic state, the sacrum fractures mostly belong to type Ⅰ and type Ⅱ (Denis classification of sacral fractures), usually involving the nerve roots. The sacrum fracture is relevant to the microstructure, the distribution of the bone trabecula, the osseous lacuna and the Haversian system of the sacrum. The fractures of the ilium and the acetabulum more frquently appear in static state, with slight wound of peripheral tissues.

Objective To evaluate the efficacy of parecoxib sodium for preemptive analgesia.Methods PubMed,EMBASE,Cochrane Library,and CNKI database were searched for randomized placebo-controlled trials involving the efficacy of parecoxib sodium for preemptive analgesia.The modified Jadad scale was used for quality assessment.Evaluation indexes included VAS scores at 1,6,12 and 24 h after operation,consumption of morphine within 24 h after operation,and incidences of nausea and vomiting after operation.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.2 software.Results Fourteen randomized placebo-controlled trials involving 1086 patients were included in our meta-analysis.The modified Jadad scale scores for the 14 studies were ≥ 4.The patients were divided into 2 groups:placebo group and parecoxib sodium 40 mg injected before operation group.The results of meta-analysis showed that VAS scores at 1,6,12 and 24 h after operation were significantly decreased,the consumption of morphine within 24 h after operation was reduced,and the incidences of nausea and vomiting after operation were decreased in parecoxib sodium 40 mg injected before operation group as compared with placebo group (P ＜ 0.05).Conclusion Intravenous injection of parecoxib sodium 40 mg before operation can produce significant preemptive analgesic efficacy and is helpful in decreasing the adverse effect of postoperative analgesia.

Conscious Sedation ; Humans ; Intubation, Intratracheal ; instrumentation ; methods

Objective: Enriching secoiridoid glycoside in Gentiana manshurica kitag. Methods: Gentiana manshurica kitag. was extracted with 70% EtOH by cold macerating and purified with AB 8 macroreticular resin. Results: The content of gentiopicrin in the extract is 28.69%. Conclusion: AB 8 macroreticular resin fits in purification of water soluble secoiridoid glycoside in Gentiana manshurica kitag.

Objective: To observe the clinical efficacy of electroacupuncture (EA) plus Tanbo-plucking the trigger points for scapulohumeral periarthritis (SP). Methods:A total of 80 patients with SP were randomized into an observation group and an EA group by the random number table, with 40 cases in each group. The EA group was treated with EA therapy, and the observation group was treated with EA therapy plus Tanbo-plucking the trigger points. After treatment, the visual analog scale (VAS) and Melle scores of the two groups were compared to evaluate the improvement of shoulder pain and functional activity, and meanwhile the clinical efficacy was observed. Results: After treatment, the total effective rate of the observation group was 95.0％ and the cure and markedly effective rate was 72.5％. The total effective rate of the EA group was 87.5％ and the cure and markedly effective rate was 42.5％. There was no significant difference in the total effective rate between the two groups (P>0.05). The cure and markedly effective rate of the observation group was higher than that of the EA group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the intra-group differences in VAS and Melle scores of both groups were statistically significant (bothP<0.001). The inter-group differences in the changes of the VAS and Melle scores after treatment were statistically significant (bothP<0.001). Conclusion: EA plus Tanbo-plucking the trigger points has a better curative effect than EA therapy alone in the treatment of SP.

Female adolescent is in the beginning of sexual maturity period and get into stage of give birth. The key points of management for the inguinal hernia of female adolescent is to cure the hernia, decrease the incidence of recurrence and the complications and protect the round ligament uterus, avoid damage to reproductive function. Tension free hernia repair is the mainly method for inguinal hernia management.Laparoscopic hernia repair is good in decrease the incidence of post operation recurrence and the chronic pain in female adolescent inguinal hernia.

OBJECTIVETo investigate the time trends of cancer mortality among residents in Kaifeng county, Henan province.

METHODSData on cancer mortality from the vital registration system in Kaifeng county from 1988 to 2005 was analyzed. A total of 9543 death records (5974 males and 3567 females) due to malignant tumors were studied. A two-year-period age-specified standardized mortality rates were directly adjusted by the world standard population, and the annual percentage change (APC) of mortality were estimated by a linear logarithm regression.

RESULTSThe crude cancer death rate for male was 95.09/100,000 and its age-standardized death rate was 117.41/100,000. While, the crude cancer death rate for female was 59.13/100,000 and the age-standardized death rate was 57.15/100,000. There was a significant growth tread for lung cancer (APC: 6.54%), liver cancer (5.07%) in males and breast cancer (7.04%) in females in the groups aged over 18. On the contrary, the decreasing treads for esophageal cancer in both of sexes (-7.09%, -13.53%) were also observed in this study. Meanwhile, there was no other significant changes in the trend, either in the tumor sites or mortality, was observed.

CONCLUSIONIn the past two decades, there has been a significant increasing trend for cancer mortality in Kaifeng county, of Henan Province. Hence, it is necessary to enhance epidemiological survey to identify risk factors at the earlier stages.

China ; epidemiology ; Death Certificates ; Female ; Humans ; Male ; Mortality ; trends ; Neoplasms ; mortality ; Rural Population

OBJECTIVETo explore the effect of electro-acupuncture to improve the bladder function after acute spinal cord injury in rats and its possible mechanism.

METHODSSixty healthy adult male SD rats of SPF grade, with body weight of 220 to 250 g, one week after feeding adaptation, were randomly divided into sham operation group, model group, electro-acupuncture group, electro-acupuncture control group with 15 rats in each group. Sham operation group underwent no stimulation, and the moderate damage model of spinal cord injury were made in other three groups according to modified Allens method. The model group were not treated, electro-acupuncture group were treated with electro-acupuncture on Zhibianxue and Shuidaoxue, and electro-acupuncture control group were treated with electro-acupuncture on 0.5 inch next to Zhibianxue and Shuidaoxue. The frequency of 2/100 Hz, current of 1 mA, stimulation time of 15 min, once a day, left and right alternately stimulate every time, for a total of 7 times. The changes of residual urine volume and urine output in rats at the 1st and the 7th days after operation were observed. And 7 d later, the rats were sacrificed and the injured spinal cord were taken out to observe the apoptosis, and to detect the changes of Bcl-2, Bax, Bad content.

RESULTSAfter modeling,the rats of three groups showed different bladder dysfunction. In electro-acupuncture group and electro-acupuncture control group, the residual urine volume of the 7th day after operation was significant lower than the 1st day after operation (P < 0.001), and there was statistically significant difference on the 7th day after operation between two groups (P < 0.001). Compared with model group, the urine output of electro-acupuncture group and electro-acupuncture control group was significantly increased on the 7th day after operation, and there was sig- nificant difference between electro-acupuncture group and electro-acupuncture control group (P < 0.001). Electro-acupuncture can inhibit apoptosis of spinal cord neurons by TUNEL detection. Postoperative at 7 d, the rate of nerve cell apoptosis in electro -acupuncture group and electro-acupuncture control group was significant increased than model group (P < 0.01, P < 0.05), and there was significant difference between electro-acupuncture group and electro-acupuncture control group (P < 0.005). Compared with model group, the positive expression rate of Bax, Bad decreased (P < 0.01, P < 0.05), and Bcl-2 increased (P < 0.01) in electro-acupuncture group and electro-acupuncture control group,there was significant difference between electro-acupuncture group and electro-acupuncture control group (P < 0.01).

CONCLUSIONElectro-acupuncture can obviously promote the repair of acute spinal cord injury,its mechanism may be through increasing Bcl-2, inhibiting the expression of Bax, Bad, which inhibits the apoptosis of spinal cord neurons.

Animals ; Apoptosis ; Electroacupuncture ; Immunohistochemistry ; In Situ Nick-End Labeling ; Male ; Neurons ; cytology ; physiology ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; pathology ; physiopathology ; therapy ; Urinary Bladder ; physiopathology

Objective To investigate the expression and function of integrin-iinked kinase (ILK) in the transdifferentiation process of primary tubular epithelial cell( TEC) and its effect on the accumulation of extracellular matrix (ECM) in the aging process. Methods Primary TEC was cultured from kidneys of male Wistar rats aged 3 and 24 months. Then the primary TEC was stimulated by TGF-? at the concentrations of 0, 5, 10 and 20-40/?g/L for 24 h. The TEC expressions of ?-SMA,ILK and F-actin were detected by immunocytochemistry or indirect immunofluorescence. FN or ILK protein expression levels were tested by Western-blot. DIG-labelled cRNA probe of rat ILK in situ hybridization was obtained by transcription in vitro, with which ILK expression level and the location of TEC were detected. Results ?-SMA expression levels were very low in young or aging rat TEC on the base situation, no significant difference was found between the two groups. However, ILK and F-actin levels in 24 months group were higher than in 3 months group. Along with increasing concentration of TGF-?, ?-SMA, ILK and F-actin levels were increased. The expression of ILK was associated with F-actin expression. FN and ILK expression levels were significantly lower in 3 monthsrats TEC than in 24 monthsrats, P

Objective To investigate the clinical characteristics, diagnosis and treatment of acute mesenteric venous thrombosis(MVT) in the elderly. Methods The clinical features, diagnosis, treatments and prognosis of 10 aged cases with acute MVT were retrospectively analyzed. Results The chief complaints of the 10 cases were different degrees of abdominal pain, which not paralleled with abdominal signs. The accompanying symptoms were nausea, vomiting and bloody stools and so on. All of these patients were misdiagnosised as pancreatitis, appendicitis or intestinal obstruction and so on. diagnosis of two cases was confirmed by ultrasound, 8 by CT. At the same time, 2 cases underwent angiography examination. Of the 8 cases who underwent operation, 5 cases were cured, 3 cases died (1 died of toxic shock and 2 died of multiple organ failure ). Two cases underwent conservative intervention thrombolysis. Conclusions It is essential to improve the knowledge of acute MVT,especially its intricate clinical characteristics, high rates of misdiagnosis and mortality. Early proper diagnosis is crucial. The main treatment is operation and conservative intervention thrombolysis can be performed in the patients whose bowel has not necrosed yet.